Analyzing the distribution characteristics of allergen sIgE in the serum of patients with respiratory and skin mucosal diseases in Shanghai City, and to provide epidemiological characteristics and diagnostic basis for the prevention and treatment of allergic respiratory and dermo-mucous diseases in Shanghai City. Adopting cross-sectional research, a total of 3 822 patients who received treatment in Tongren Hospital, Shanghai Jiao Tong University School of Medicine from July 2022 to July 2023 due to respiratory diseases or skin and dermo-mucous symptoms were included. Among them, there were 1 456 males and 2 366 females, with an age range of 1-97 years old. The median age (interquartile range) was 33 (27, 44) years old. The sIgE was detected by using immunoblotting. Statistical analysis was conducted using SPSS 22.0 software, and the comparison of count data (rates) between groups was conducted using χ2 test. The results showed that a total of 3 377 (88.4%) cases among 3 822 patients were at least one allergen sIgE positive, and 72.9% (2 788/3 822) of them were multiple allergies sIgE positive. The top five allergen sIgE positive rates were Dermatophagoides pteronyssinus (37.9%, 1 447/3 822), Dermatophagoides farinae (32.1%, 1 225/3 822), milk (31.7%, 1 211/3 822), fungi (28.3%, 1 080/3 822), and Blomia tropicdis (23.8%, 909/3 822), with only milk was a kind of food allergen. The highest positive rates within the respiratory system disease group or dermo-mucous disease group were also these five allergens, without any difference in disease categories. The positive rates of cat dandruff, Humulusscandens, and juniper/birch in the respiratory system disease group were significantly higher than those in the skin and mucous membrane disease group, while the positive rates of shrimp/crab were relatively low (11.3% vs 14.9%, χ2=9.616,P=0.002). Whether in the respiratory system disease group or the dermo-mucous disease group, the positive rates of Dermatophagoides pteronyssinus in male patients were significantly higher than those of females(42.6% vs 35.7%,41.0% vs 34.4%), with statistical significance (χ2=12.515, P<0.001; χ2=5.143, P=0.023), And the three allergens, Dermatophagoides farinae, cat dander, and egg white allergens are also characterized by this feature.In addition, the positive rates of milk(33.8% vs 30.1%, χ2=3.911, P=0.048), shrimp/crab(13.2% vs 10.0%, χ2=6.423, P=0.014) in the respiratory system disease group were higher in males than in females, while in the dermo-mucous disease group, dog dander(20.5% vs 14.6%, χ2=6.726, P=0.010) and peanuts/soybeans(10.5% vs 6.9%, χ2=4.698, P=0.030) showed this phenomenon. In both the respiratory system disease group and the dermo-mucous disease group, there were 6 types of inhaled allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicdis, cat dandruff, dog dander, fungi) and 4 types of food allergens (egg yolks, egg white allergens, milk, shrimp/crab). However, the positivity rate of Aspergillus fumigatus (7.2% vs 9.3% vs 10.5% vs 15.7%, χ2=10.996, P=0.012)in the respiratory disease group and cockroaches(4.2% vs 11.3% vs 9.6% vs 16.4%, χ2=10.237, P=0.017) in the skin and mucosal disease group was the lowest in the underage group. There are seasonal differences in the positivity rates of allergens, with most allergens having significantly higher positivity rates in summer and autumn. In conclusion, the most common allergens sIgE positive in patients with respiratory and dermo-mucous diseases in Shanghai City are Dermatophagoides pteronyssinus, Dermatophagoides farinae, milk, fungi, and Blomia tropicdis. The trend of allergen sIgE prevalence in the two major categories of diseases is basically consistent. Allergen sIgE distribution varies among patient populations of different gender, age or season, and clinical prevention and treatment can be based on the results of serum allergen testing.
分析上海地区呼吸及皮肤黏膜疾病患者血清特异性免疫球蛋白E（sIgE）的分布特征，为过敏性相关的呼吸及皮肤黏膜疾病的防治提供参考依据。采用横断面研究，纳入2022年7月至2023年7月因呼吸疾病或皮肤黏膜症状在上海交通大学医学院附属同仁医院就诊的患者共3 822例，其中男性1 456例，女性2 366例，年龄范围1~97岁，中位年龄（四分位间距）为33（27，44）岁。通过使用免疫印迹法对血清过敏原sIgE 进行检测，并采用SPSS 22.0软件进行统计分析，各组间计数资料（率）的比较采用χ2检验。结果显示，3 822例患者有3 377例（88.4%）至少有1种过敏原sIgE阳性，其中72.9%（2 788/3 822）为多重过敏原sIgE阳性。过敏原sIgE总阳性率位于前五位的分别是户尘螨（37.9%，1 447/3 822）、粉尘螨（32.1%，1 225/3 822）、牛奶（31.7%，1 211/3 822）、真菌类（28.3%，1 080/3 822）和热带无爪螨（23.8%，909/3 822），其中只有牛奶为食入性过敏原。而在呼吸疾病组和皮肤黏膜疾病组内部阳性率最高的也是这5种，未因疾病大类有所差异。呼吸疾病组中猫毛皮屑、葎草和刺柏/桦的阳性率明显高于皮肤黏膜疾病组，虾/蟹的阳性率则相比较低（11.3% vs 14.9%，χ2=9.616，P=0.002）。无论是在呼吸疾病组或是皮肤黏膜疾病组，男性户尘螨的过敏原sIgE的阳性率明显高于女性（42.6% vs 35.7%，41.0% vs 34.4%），差异有统计学意义（χ2=12.515，P<0.001；χ2=5.143，P=0.023），并且粉尘螨、猫毛皮屑和鸡蛋白这3种过敏原也是这一特征。除此之外，呼吸疾病组中阳性率表现为男性高于女性的过敏原还有牛奶（33.8% vs 30.1%，χ2=3.911，P=0.048）和虾/蟹（13.2% vs 10.0%，χ2=6.423，P=0.014），皮肤黏膜疾病组中则是狗毛皮屑（20.5% vs 14.6%，χ2=6.726，P=0.010）、花生/黄豆（10.5% vs 6.9%，χ2=4.698，P=0.030）表现为该现象。在呼吸疾病组和皮肤黏膜疾病组中均有6种吸入性过敏原（户尘螨、粉尘螨、热带无爪螨、猫毛皮屑、狗毛皮屑和真菌类）以及4种食入性过敏原（鸡蛋黄、鸡蛋白、牛奶和虾/蟹）表现为未成年组阳性率较青年组、中年组和老年组为高。但是，在呼吸疾病组中的烟曲霉（7.2% vs 9.3% vs 10.5% vs 15.7%，χ2=10.996，P=0.012）以及皮肤黏膜疾病组中的蟑螂（4.2% vs 11.3% vs 9.6% vs 16.4%，χ2=10.237，P=0.017）的阳性率表现为未成年组最低。过敏原sIgE阳性率之间存在季节差异，大多数过敏原在夏秋季的阳性率明显较高。综上，2022—2023年因呼吸疾病或皮肤黏膜症状在上海交通大学医学院附属同仁医院就诊的患者中最常见的过敏原sIgE阳性为户尘螨、粉尘螨、牛奶、真菌类和热带无爪螨，两大类疾病的过敏原sIgE分布趋势基本一致。在不同性别、不同年龄、不同季节的患者群体中，过敏原分布不同，临床可根据血清过敏原sIgE检测结果为疾病提供防治依据。.